Metastasis occurs when cancer cells acquire a migratory epithelial-to-mesenchymal transition (EMT) phenotype, initiated from groupings of cells that appear to break off from primary tumors. Invasive phenotype is the fundamental property of such cells in correlation with their invasion to endothelial vascular layer in the beginning of the metastasis. Identifying metastatic cancer cells in a sample resected from the secondary tissue of the patients by biopsy, core needle biopsy (CNB), endoscopy, colonoscopy, Lymph node aspiration, and fine needle aspiration (FNA) is the most important step in cancer staging and therapeutic regimes.
Accurate detection of the occurrence of metastasis in the samples removed by biopsy has a major impact on patients' survival rates. Existing pathological methods are designed to track the presence of abnormally aggressive cells in the fixed samples prepared from removed tissues by cytological and immunohistochemical staining procedures. The small volume of the biopsied tissue from the organs in question for metastasis results in limited number of histopathological samples investigated by pathologists and reduces rates of accurate diagnosis especially in early stages of metastasis. Current molecular technologies specifically negatively limit the ability to demonstrate metastasis in biopsy samples with low cellular population. Although cancer cells are detectable in some cases using traditional methods, they might be rare or only exist in regions of the removed sample that are not investigated by a pathologist, thereby leading to missing any aggressive cancer cells. Accordingly, to do a detailed analysis using traditional methods which doesn't miss any cancer cells is both time consuming and expensive.
Therefore, there is a need for an approach, a system, and a method to accurately detect the presence of metastasis in unprocessed samples for cancer diagnosis, prognosis, drug development, and cancer treatment applications. A chemistry-free approach may enable specific and label-free efficient capture of metastatic cells with a simple, fast, and chemistry free method in small biopsy samples which will improve the diagnostic impact of CNB before surgery or therapeutic treatments.